Medicaid Spending for Depression Rose in Past Decade

WEDNESDAY, Dec. 7 (HealthDay News) — While spending for Medicaid patients with depression has increased substantially, there have been only small improvements in care, a new study shows.

Researchers analyzed data from Medicaid patients treated for depression in Florida between July 1996 and June 2006. The patients, aged 18 to 64, had one or more hospitalizations for depression or had at least two outpatient claims of depression on different days.

There were between 8,970 and 13,265 patients each year, with a total of 56,805 during the entire study period.

Over 10 years, spending increased from an average of $2,802 per patient to $3,610 per patient, a 29 percent increase. This increase was due to a 110 percent rise in drug spending, most of which was the result of a 949 percent increase in spending on antipsychotic drugs, according to a journal news release.

The percentage of patients who used antidepressants rose from 81 percent to 87 percent, the use of anxiety medications remained stable (from 63 percent to 64 percent), and the use of antipsychotic drugs increased from 26 percent to 42 percent of patients.

The percentage of patients who received psychotherapy fell from 57 to 38 percent and the percentage of patients who were hospitalized decreased from 9 percent to 5 percent. The researchers also found a decrease in the number of follow-up visits.

“In summary, during the 10-year period between 1996 and 2005, we found a substantial increase in spending for patients with depression, with minimal improvements in quality of care,” concluded Dr. Catherine Fullerton, of Harvard Medical School and Cambridge Health Alliance, and colleagues in the release.

“Our findings underscore the importance of continued efforts to improve quality of care for individuals with depression, as well as the need to understand the efficacy and cost-effectiveness of using antipsychotics for the treatment of individuals with depression in the general community.”

The study appears in the December issue of the journal Archives of General Psychiatry.

More information

The U.S. National Institute of Mental Health has more about depression.

Are You Living with Psoriasis?

A growing knowledge of the skin disease called psoriasis is leading to greater treatment choices, including personalized therapies, the U.S. Food and Drug Administration reports.

Psoriasis is an immune system disorder that causes overproduction of skin cells, resulting in scaling, pain, swelling, redness and heat. The condition affects about 7.5 million Americans.

“As we better understand the disease, researchers know more about what specific factors to target in order to develop effective treatments,” FDA dermatologist Dr. Melinda McCord said in an agency news release.

There is no cure for psoriasis, so the main goals of treatments are to stop skin cell overproduction and reduce inflammation. Current therapies include medicines applied to the skin (topical), light treatment (phototherapy), or drugs taken by mouth or given by injection.

Doctors used to take a step-by-step approach, starting patients with mild to moderate psoriasis on topical therapy. If that was ineffective, doctors moved on to phototherapy or drug treatment.